Each year around 5400 people in England and Wales die after being severely injured – for example, in a road traffic collision, or as a result of a major fall. The leading cause of preventable death following injury is uncontrolled bleeding, which usually requires immediate surgery. However, some patients die before they can reach an operating theatre.
REBOA (which stands for Resuscitative Endovascular Balloon Occlusion of the Aorta) is a new technique which could help with this. REBOA involves passing a small inflatable balloon into the aorta (the main artery) to stop the bleeding until a patient can be taken to an operating theatre.
The UK-REBOA study was funded by the NIHR HTA programme and aimed to compare standard major trauma centre care with REBOA versus standard major trauma care alone.
The primary outcome was mortality at 90 days.
Ninety patients aged 16 years or older with exsanguinating haemorrhage were enrolled between October 2017 and March 2022; 89 were included in the primary outcome analysis because 1 patient declined to consent for continued participation and data collection. At 90 days, 25 of 46 patients (54%) had experienced all-cause mortality in the REBOA plus standard care group compared to 18 of 43 patients (42%) in the standard care alone group (odds ratio [OR], 1.58 [95% credible interval, 0.72-3.52]; posterior probability of an OR >1 [indicating increased odds of death with REBOA], 86.9%). In trauma patients with exsanguinating haemorrhage, a strategy of REBOA and standard care in the emergency department does not reduce, and may increase, mortality compared with standard care alone.
UK-REBOA was led by Dr Jan Jansen based at the University of Alabama and HSRU, University of Aberdeen.
For more information please see the UK REBOA Study Website
Contacts
- Seonaidh Cotton; s.c.cotton@abdn.ac.uk
- Gillian Ferry; gillian.ferry@abdn.ac.uk
Status
CompletedPublications
Jansen JO, Cochran C, Boyers D, et al; UK-REBOA Trial grantholders. The effectiveness and cost-effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) for trauma patients with uncontrolled torso haemorrhage: study protocol for a randomised clinical trial (the UK-REBOA trial). Trials. 2022;23(1):384. doi:10.1186/s13063-022-06346-1
Lawrie, L., Duncan, E.M., Jansen, J.O. et al. Behavioural optimisation to address trial conduct challenges: case study in the UK-REBOA trial. Trials 23, 398 (2022). https://doi.org/10.1186/s13063-022-06341-6
Jansen JO, Hudson J, Cochran C, et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023;330(19):1862–1871. doi:10.1001/jama.2023.20850